Objective To evaluate the clinical effects of color Doppler ultrasound in perforating vein closure by foam sclerotherapy for the treatment of venous leg ulcer.Methods Choosing the patients with venous ulcers (classified as C6) that underwent superficial and perforating veins closure by ultrasound-guided foam sclerotherapy in the Department of Vascular Surgery,First Affiliated Hospital of Chongqing Medical University,during December 2014 to August 2016.All patients were followed up by color Doppler scanning for veins closure,and the postoperative healing of skin ulcers were observed at the same time.Results A total of 114 patients with 119 limbs were enrolled,which were confirmed 1-3 perforating vein lesions by ultrasound.An average of 2.1 perforators were closed per leg (1-3 perforators).The average follow-up period was 11.3 months (1-21 months).The healing rate is 100％ and all the insufficient perforating veins were occlusion 1 month postoperative.Three cases of ulcer recurrence,and 8 cases of insufficient perforator recanalization were found.Serious complications did not appear.Conclusions Color doppler ultrasound can improve the safety and efficacy of perforating vein closure by foam sclerotherapy for the treatment of venous leg ulcer,and it has a high clinical value.

Objective To explore the clinical outcome with anterior debridement,bone graft and posterior internal fixation with short nail of treating intervertebral infection.Methods Ninteen cases (11 male and 8 female,aged from 34 to 63,46 on average) of lumbar intervertebral space infection treated in our hospital from June 2008 to June 2013 were retrospectively analyzed.These infections occurred at L2-L3 in 2 cases,L3-L4 in 5 cases,L4-L5 in 8 cases and L5-S1 in 4 cases.All patients had history of disc surgery or puncture.The clinical outcome after operation was analyzed according to the low back paine after operation which analyzed by visual analog scale (VAS),and the bone fusion.Erythrocyte sedimentation rata and C-reactionprotein were aslo recorded before and after surgery.Results All cases were followed up,average 24 months.The lower back pain was improved obviously between preoperation and postoperation (P ＜0.05).Also erythrocyte sedimentation rata and C-reactionprotein returned to normal after the operation and all cases had complete bone union at the end of follow-up with no instrument failure noted.Conclusion Anterior debridement,bone graft and posterior internal fixation with short nail in of treating intervertebral infection not only can effectively reconstruct the stability of the spine,but also retain range of motion segment of spine.

Objective To analyze the long-term survival of patients with middle and distal cholangiocarcinoma,and to explore the influence of nerve invasion on the survival time.Methods We retrospectively analyzed the clinical data of 161 patients with middle or distal cholangiocarcinoma in General Hospital of Fushun Mining Bureau between January 2012 and June 2016.All the patients were divided into nerve group and control group according to the nerve invasion.And then the perioperative and prognosis data of the two groups were analyzed and compared.Results In our research,all patients were successfully completed surgery,the incidence of neural invasion was 47.2％ (76/161),more common of the nerve invasion in distal cholangiocarcinoma and phase Ⅱ cholangiocarcinoma.The perioperative mortality rate was 3.7％ (6/161),and the incidence of complications was 27.3％ (44/161).The 1 years,2 years and 3 years survival rates of middle and distal cholangiocarcinoma were 78.7％,42.1％,20.0％,the average survival time was(23.8 ±1.2) months.The 1 years,2 years and 3 years survival rates of nerve group and control group were 67.1％,29.8％,9.4％ and 89.0％,52.6％,26.8％,the average survival time were (18.6 ± 1.4) months and (27.3 ± 1.6) months.The prognosis of nerve group was significantly poor than the control group (P ＜ 0.05).Conclusions Nerve invasion is a common way of invasion and metastasis of cholangiocarcinoma.And it has a poor prognosis in cholangiocarcinoma patients with nerve invasion.

Objective To explore the clinical application and value of endoscopic surgery in the treatment of hypertensive cerebral hemorrhage assisted with neuronavigation,we compared it with traditional craniotomy.Methods We collected hypertensive cerebral hemorrhage patients with the application of neuronavigation assisted endoscopic surgery from January 2012 to November 2015,and randomly selected 30 cases as experimental group;and collected hypertensive cerebral hemorrhage patients with craniotomy and then randomly selected 30 cases as the control group.What did we respectively record about the two groups were postoperative GCS score,skin incision length,operation time,bleeding volume,length of stay,postoperative complications,and KPS score of the postoperative follow-up of sixth months;after that,the dates of the two groups were compared and analyzed.Results Compared the experimental group to the control group,postoperative GCS score did not achieve statistically significant difference (P ＞ 0.05);in the skin incision,there was statistically significant difference between two groups (P ＜ 0.05),the average incision length in the experimental group was (4.25 ±0.44) cm,however it was (13.27 ± 1.01) cm in the control group;as for the operation time,it was averagely (93.93 ±21.04) min for the experimental group,and (176.50 ± 35.65) min for the control group,there was statistical difference between two groups (P ＜0.05);with regard to the amount of intraoperative bleeding,the mean amount in the experimental group was (69.83 ± 23.83) ml,and (196.17 ± 33.83) ml in the control group,the difference was statistically significant (P ＜ 0.05);and the average hospitalization days for the test group was (13.33 ± 1.79) d,(16.20 ± 4.31) d for the control group,it was considered statistically significant (P ＜ 0.05);in complications,the test group incidence was significantly lower than that in the control group,the difference between the two groups has statistical significance (P ＜ 0.05);after postoperative follow-up of 6 months,we found that the prognosis of experimental group is better than that of control group,and statistical significance was described by analyzing the KPS scores of two groups (P ＜ 0.05).Conclusions Neuronavigation assisted endoscopic technique in the treatment of hypertensive cerebral hemorrhage has many advantages,such as accurate localization,direct vision,perfect hemostasis,and less bleeding.It is minimally invasive and can also shorten the operation time as well as lengths of stay.Besides,it can reduce the incidence of complications and bring better postoperative recovery.

Stress ulceration are common occurrence in patients with severe traumatic brain injury, which can result in alimentary tract hemorrhage, perforation and obviously increase mortality. To prevent the occurrence of stress ulceration and control upper gastrointestinal hemorrhage is meaningful for prognosis of critical disease. This article reviews pathogenesis of stress ulceration as well as the relationships preventive treatment, early enteral nutrition, hospital acquired pneumonia and related complications.

Objective To evaluate the postoperative quality of life of donors in living donor renal transplantation patients.Methods One hundred and seventeen donors were involved in present study from 2006-2008.A crosssectional survey was performed with questionnaire research to all the donors who received living donor nephrectomy during this period.The questionnaire included sociodemographic characteristics,surgical complications,economic status,donors awareness status,family support,the health care,social welfare and daily exercise after surgery.The Chinese version of SF-36 was used as the measurement of quality of life.The statistic analyze include T test,analysis of variance and stepwise regression analysis.Results The donors' mental health status was better than the healthy population (P ＜ 0.05).The difference of quality of life and scores of other dimensions compared with the healthy population was not statistically significant (P ＞ 0.05).In univariate analysis,four kinds of fields such as age,education level,economic status and physical exercise were associated with quality of life.In further multivariate analysis,with exclusion of the interaction between various factors,the main factors for postoperative quality of life are the cultural,economic status and physical activity (P ＜ 0.05).Conclusions Social and psychological factor should be concerned in donor's preoperative screening.Good social psychological background,the necessary psychological intervention and postoperative follow-up maybe play an important role to improve the postoperative quality of life in living donor renal transplantation.

Objective To analyse and summarise of the clinical effect and operative opportunity laparoscopic cholecystectomy for acute mild unobstructed gallstone pancreatitis.Methods Fify-four gallstone pancreatitis patients were treated as observation group in the first people's hospital of yangzhou from December 2012 to September 2015,which were treated with laparoscopic cholecystectomy after two weeks,while 53 patients which were treated with laparoscopic cholecystectomy after three months were treated as control group.The treatment effect,operation time,hospitalization time and total cost.Results There were no deaths,no bile duct injury and biliary fistula,the total hospitalization time [(19.8 ±2.6)d vs (26.5 ±3.5) d],the total cost [(2.6282 ± 0.2451) vs (3.2892 ± 0.3982)],recurrent pancreatitis rate (0) were lower than the control group(9.4％),the recovery rate of liver function were higher than the control group,there was significant difference between two groups(P ＜ 0.05),however,there was no significant difference between two groups for postoperative complications and operation time (P ＞ 0.05).Conclusions For acute mild unobstructed gallstone pancreatitis patients,the safe and feasible operative opportunity was recommended two weeks after the symptoms were completely improved,Laparoscopic cholecystectomy in the treatment of acute gallstone pancreatitis can promote recovery,shorten the hospitalization time.

Pancreatic cancer is a one of the most malignant digestive cancer.Because the lack of effective methods for early diagnosis,most patients have been ineligible for surgical resection when diagnosed.Kallikrein family is a group of serine proteases,because of its ability to decompose the extracellular matrix proteins,it may be closely related to the invasion and metastasis of various cancers.And some members of kallikrein family may become cancer diagnostic biomarkers.This paper reviews all the recent articles about kallikrein family study in pancreatic cancer.

Pancreatic cancer is one of the deadliest cancers of the digestive tract with an obviously increasing incidence around the word in recent years.It is diffcults to diagnosis in the early stage because of the deficience of specific symptoms.Radical resection is the most effective method to treat pancreatic cancer,but those patient often lose radical surgery opportunity when be diagnosised at advanced stages.Their prognosis is poor.Early diagnosis can greatly improve the rates of radical resection and promote the prognosis of the disease,and reliable tumor markers can be used for early screening and early diagnosis for pancreatic cancer.In recent years,the rapidly development of proteomics and its technology makes tumor markers become a popular research fields in pancreatic cancer.

Objective To compare the safety and effect of the holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate(TURP) for benign prostatic hyperplasia(BPH).Methods Three hundred and forty-nine cases with benign prostatic hyperplasia were divided into HoLEP group (172 cases) and TURP group(177 cases).All patients were assessed preoperatively,then we recorded hemorrhage volume,operation time,catheter indwelling time and complication rate.Follow-up 3 months,postvoid residual(PVR),maximal urinary flow rate(Qmax),international prostate symptom score(IPSS),quality of life score(QOL) were analyzed.Results Hemorrhage volume,operation time,catheter indwelling time in HoLEP group were significant less than TURP group(P ＜ 0.05),complication rate of HoLEP group was lower than that of TURP group(P ＜ 0.05).After 3 months follow-up,IPSS,Qmax,PVR,QOL were obviously improved in both groups compared with preoperation (P ＜ 0.05).Conclusions HoLEP is safer than TURP on the base of same effectiveness,it is an promising surgical method for BPH patients.